Congenital Dacryocele With Large Intranasal Cyst

Ali, Mohammad Javed; Psaltis, Alkis J.; Brunworth, Joe; Naik, Milind N.; Wormald, Peter‐John

doi:10.1097/iop.0000000000000206

Cited by 21 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…D-F). 10 Mild dilatation of the nasolacrimal duct was a common finding, as could be expected in such cases. Of the 13 infants with complex CNLDO, 4 had lacrimal sac diverticula (19%), 7 had intranasal cysts (33%), 1 each (5%) had gross atonic sac, buried probe, and a bony nasolacrimal duct obstruction.…”

Section: Methodsmentioning

confidence: 67%

See 1 more Smart Citation

Congenital Nasolacrimal Duct Obstruction Update Study (CUP Study): Paper 4—Infantile Acute Dacryocystitis (InAD)—Presentation, Management, and Outcomes

Bothra

Ali

2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

Self Cite

View full text Add to dashboard Cite

Purpose: To study the presentation, management, and outcomes of infantile acute dacryocystitis. Methods: Retrospective study of infants diagnosed with acute dacryocystitis over a period from June 2016 to December 2019. Data collected include demographics, clinical history, presenting features, management, complications, and outcomes. Treatment provided was intensive medical care followed by early probing under endoscopic guidance. Further interventions, where needed, were performed based on intraoperative findings during probing. Successful outcomes were defined as resolution of infection, subjective relief from epiphora, and anatomical patency determined by a normal fluorescein dye disappearance test. Results: Twenty-seven eyes of 27 infants were analyzed during the study period. The mean age of infants was 3.26 months, and males were more affected than females (male:female 15:12). The mean duration of symptoms was 4.66 weeks, with 96% (26/27) presenting with symptoms of redness, watering, discharge, and swelling. Preseptal cellulitis was seen in 74% (20/27) infants, lacrimal abscess in 67% (18/27) infants, and lacrimal fistula in 37% (10/27). Most infants had complex congenital nasolacrimal duct obstruction (62%, 13/27), of which 7 also had intranasal cysts. One infant successfully underwent endoscopic dacryocystorhinostomy. At a mean follow-up period of 7.95 months, successful outcomes were observed in 90.4% (19/21) infants. The 2 failed cases were complex congenital nasolacrimal duct obstruction with associated sac diverticula and are scheduled for an endoscopic dacryocystorhinostomy. Conclusion: Infantile acute dacryocystitis is a distinct clinical entity. The outcomes of systemic antibiotics and early probing are excellent.

show abstract

Section: Methodsmentioning

confidence: 67%

“…2,[5][6][7][8][9] Intranasal cysts, if present, may need a marsupialization for better outcomes. 10 Bacteremia also poses a significant risk in infants with infected lacrimal sacs. Preoperative bacteremia in infants has been reported to be close to 23%.…”

mentioning

confidence: 99%

Congenital Nasolacrimal Duct Obstruction Update Study (CUP Study): Paper 4—Infantile Acute Dacryocystitis (InAD)—Presentation, Management, and Outcomes

Bothra

Ali

2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…16 In the setting of a dacryocele, the prevalence of PAD varies from 20% to as high as 76%. 6,11,12,[17][18][19][20] In the authors' series, a high percentage of children were found to be incorrectly diagnosed with dacryocystitis by their general pediatrician based on tearing or discharge alone. Many of these cases actually represented noninfected congenital NLDO, characterized by repeated bouts of eyelid crusting and mucopurulent discharge.…”

Section: Discussionmentioning

confidence: 93%

“…16 In the setting of a dacryocele, the prevalence of PAD varies from 20% to as high as 76%. 6,11,12,17–20…”

Section: Discussionmentioning

confidence: 99%

Management of Pediatric Acute Dacryocystitis

Prat

Magoon

Revere

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Purpose: To analyze the clinical presentation, course, and management in a large cohort of pediatric acute dacryocystitis subjects and to examine whether hospitalization and urgent surgical intervention are indeed mandatory. Methods: A retrospective analysis of all pediatric subjects diagnosed with dacryocystitis at the Children’s Hospital of Philadelphia over a 12-year period (2009–2020). Results: One-hundred sixty-nine pediatric acute dacryocystitis patients were included in this study. Management included admission in 117 cases (69%). Sixty-eight patients (40%) were treated medically with no surgical intervention, 75 cases (44%) required urgent surgical intervention, and 26 additional cases (15%) required surgery due to persistent tearing symptoms after medical management. The urgent procedures included most commonly: 1) endonasal examination and microdebridement of intranasal cysts in 26 cases (35%); 2) probing and irrigation without examination and microdebridement, with or without stent intubation, in 30 cases (40%); and 3) dacryocystorhinostomy (13 endonasal and 4 external) in 17 cases (23%). Conclusions: Management of pediatric acute dacryocystitis should be tailored individually for each case. Hospital admission and early surgical intervention are not mandatory, as 31% of cases resolved without admission, and 56% without early surgical intervention. Although a specific age cutoff is not plausible, hospital admission for younger patients is more commonly advocated. When surgical intervention is indicated, endonasal examination and microdebridement of any associated intranasal cyst and probing with possible stenting are the initial procedures of choice. Dacryocystorhinostomy is reserved for more complex obstructions. Although pediatric acute dacryocystitis is an infection with serious potential problems, when managed appropriately, complications are rare.

show abstract

“…DE-assisted nasal endoscopic marsupialization for congenital dacryocystocele were studied with localization of a deflated intranasal cyst after a n initial incision of the cyst [ 31 ]. They made a cruciate incision on the medial wall of the dacryocystocele using a sickle knife for marsupialization [ 32 , 33 ]. In membranous CNDOs older than 1 year with history of initial probing failure, direct DE-assisted incision of Hasner’s valve under nasoendoscopy was introduced.…”

Section: Resultsmentioning

confidence: 99%

Clinical Implication of Dacryoendoscopy in the Patients with Tearing: A Systematic Review

Kim¹,

Park²,

Lew³

2023

Korean J Ophthalmol

View full text Add to dashboard Cite

Purpose: A systematic review of the literature on diagnostic and therapeutic indications, techniques, and complications of dacryoendoscopy (DE) was performed. Methods: The authors performed a PubMed search of articles published in English on DE. Data was collected and classified according to the categories of the disease. And the clinical outcomes and limitations were particularly analyzed.Results: The lacrimal drainage system from the canaliculus to the inferior meatus could be examined based on the specific anatomical features by DE. The canalicular mucosa is smooth and brightly colored, the lacrimal sac shows covering mucosa with good vascularization and the nasolacrimal duct is lined with bright tubular mucosal folds. DE allows direct visualization of the detailed internal condition of the lacrimal disorders, to directly diagnose the site of obstruction with accuracy and address the causes and recanalize the lacrimal drainage system using assisted micro lacrimal surgical instruments in the tearing patients. Conclusions: Better visualization of the lacrimal canal with DE improves the understanding of physiology and precise identification of the obstructing lesions, both of which are the key to a comprehensive management for the tearing patients.

show abstract

Congenital Dacryocele With Large Intranasal Cyst

Cited by 21 publications

References 17 publications

Congenital Nasolacrimal Duct Obstruction Update Study (CUP Study): Paper 4—Infantile Acute Dacryocystitis (InAD)—Presentation, Management, and Outcomes

Congenital Nasolacrimal Duct Obstruction Update Study (CUP Study): Paper 4—Infantile Acute Dacryocystitis (InAD)—Presentation, Management, and Outcomes

Management of Pediatric Acute Dacryocystitis

Clinical Implication of Dacryoendoscopy in the Patients with Tearing: A Systematic Review

Contact Info

Product

Resources

About